Organization
EVENTIDE SENIOR LIVING COMMUNITIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WADE E STUBSON (CFO)
21829122216
Entity
Organization
Contact information
Practice address
225 13TH AVENUE WEST, WEST FARGO, ND 58078
(701) 478-6000
Mailing address
1405 7TH ST S, MOORHEAD, MN 56560-3444
(218) 233-7508
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
63
ND
311500000X
Alzheimer Center (Dementia Center)
Primary
8100A
ND
Other
Enumeration date
03/02/2007
Last updated
09/11/2025
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